Provider Demographics
NPI:1407982341
Name:GINSBERG, EDWIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:GINSBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E SHORE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2433
Mailing Address - Country:US
Mailing Address - Phone:516-466-1070
Mailing Address - Fax:516-466-6367
Practice Address - Street 1:233 E SHORE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2433
Practice Address - Country:US
Practice Address - Phone:516-466-1070
Practice Address - Fax:516-466-6367
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0347061223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics